Foundations Final

92 flashcards · Other · by Jared Blackwell

  1. MAHA Hemolytic anemia Due to trauma, fibrin occlude vessels. Thrombocytopenia Hemolysis symptoms Schistocytes- helmet, triangle cells. *Mechanical trauma

  2. Heriditary Sperocytosis HS - Hemolytic anemia Triad: Pallor, Jaundice, Splenomegaly Elevated MCHC. Dehydration K+ loss. Increase LDH, direct bilirubin Increased osmotic fragility. *Structural abnormalities

  3. G6PD Deficiency - Hemolytic anemia. X-linked Old RBC lyse with ROS Reticulocytosis Blister cells Heniz Bodies *Structural abnormalities

  4. Describe Paroxysmal Nocturnal hemoglobinuria

    Lysis of PMNs, platelets, etc. Mutation in PIG-A on X chromosome. Increased complement-mediated intravascular RBC lysis. Hemoglobinuria Diagnosis with Coombs negative hemolytic anemia, pancytopneia, venous thrombosis.

  5. Hemoglobin S Disease aka Sickle Cell anemia. HbS B-globin mutation Glu --> Val. Tissue damage, pain Autosplenectomy

  6. Iron Deficiency Anemia LOW MCH, ferritin High transferrin Low reticulocyte Anemia of Chronic Inflammation: Increased IL-1/6 TNF-a, IFN-y Increase Hepcidin by liver (insulin to glucose for iron). Decreased EPO, transferrin Increased ferritin, C-Protein

  7. Megalobaslic anemia GIANT erythoblasts LDH INCREASED B12 Deficiency: Pernicious anemia Loss of Intrinsic Factor-IF Gastrin INCREASED Methylamalonic acid INCREASED Folate Deficiency: Check folate serum levels.

  9. Duchenne Muscular Dystrophy X-linked, 100% penetrance. Nonsense mutation. Dystrophin connects Actin muscle to Sarcolemma. Replacement with adipose. -Macrophages, variable muscle size. Becker Muscular Dystrophy is parital loss of dystrophin by point mutations.

  10. What is a Promoter?

    Needed for initiation of transcription by RNA Pol. Core promoter and regulatory promoter.

  11. What is the General Transcription Factor; TFIID?

    TFIID recognize individual Core Promoter elements on RNA Pol II. TFIID forms PIC, then other TFs and RNA Pol II join.

  12. Steps of mRNA processing

    Addition of 7-MeG Cap Capping immediately after RNA Pol II leaves promoter. 2.Splicing. 5' splice site cleaved by attack of branchpoint OH 3' splice cleaved by attack of exon 1 with OH. Fusion of exons. 3.Poly A-tail Cleavage downstream of AAUAAA signal.

  13. How does Myc-Max-Mad system control cell growth and proliferation?

    Myc dimerizes with Max and bind E-box enhancer. GROWTH Myc replaced; Max + Mad dimer and inhibits growth.

  14. Describe the Iron Response Protein

    When iron low, IRP binds iron response element and inhibits translation of Ferritin. High iron, IRP leaves and and ferritin translation turned on. **Translation regulation: Regulatory signals that bind RNA binding proteins are contained in 5' and 3' UTRs.

  15. Describe miRNAs

    miRNAs come from own genes or introns. Pre-miRNAs --> cytoplasm, processed by Dicer to form ds-miRNA. Passenger strand is separated and placed in RISC. RISCs bind mRNA at 3' UTRs and decrease mRNA stability or degrade. Perfect match= degrade. *Critical for stem cell regulation.

  16. Describe Distal and Proximal Histidine. Also metHb

    Distal His binds and stabilizes the oxygen: Fe2+. Proximal His binds directly to Fe. metHb lacks 6th electron to bind O2. MetHb reductase converts it to Hb.

  17. a-Thalassemias: 1 abnormal loci 2 abnormal loci 3 abnormal loci 4 abnormal loci

    There are 4 a-globin loci, 2 on each chromosome. 1 abnormal loci - NO symptoms 2 abnormal loci - alpha thalassemia MINOR. 3 abnormal loci: -Hb Barts in fetus y4. -In Adults becomes HbH disease B4. 4 abnormal loci- Hydrops fetalis.

  18. -B/B+ to B/B0 -B0/B+ to B+/B+ -B0/B+ to B0/B0

    -B/B+ to B/B0 Minor, asymptomatic -B+/B+ to B0/B+ Intermedia -B0/B+ to B0/B0 Major, need transfusion, lifelong.

  19. Describe T and R states

    Tense state has interactions, STABLE. Low affinity for oxygen. HisHC3 outside Fe below prophyrin ring Relaxed state has HIGH affinity for oxygen. Flexible. HisHC3 inside Oxygen binds T state, breaks ion pairs, salt bridges between a1-b2; switch to R state. Fe now even with porphyrin ring because proximal His changed conformation.

  20. What does a decrease in pH and increase in acidity do to curve?

    Shifts to the right. H+ binds to Hb and stablizes T state. Low affinity for oxygen, gives to tissues.

  21. Describe 2,3-BPG function in Hb

    BPG small negative charge, binds central cavity of Hb. His+ and Lys+ Stabilizes T state. Without 2,3-BPG Hb curve would look like Mb. Low PO2, RBCs make BPG to help oxygen deliver to tissues.

  22. Difference in central cavity of adult Hb and HbF?

    His+ is replaced by Ser- in HbF. Few positive charges lowers BPG binding.

  23. How does Hb help with acid-base homeostasis?

    Hb buffers 50% of acid by protanation of His. Hb binds 15% of metabolic CO2 Hb converts CO2 to Carbonic acid then Bicarbonate. CO2--> Hb. CO2 + H2O --> H2CO3 --> HCO3- --> leaves RBC.

  24. Proliferative capacity of cell types?

    Continuously cycling labile cells Epidermis, GI tract Quiescent stable cells Liver, kidney Nondividing permanent cells Heart, neuron

  25. What is Lipofuscin?

    Seen in cells undergoing atrophy due to age. Lipofuscin changes color of liver.

  26. Squamous metaplasia in lung. Columnar epithelium to squamous due to smoke.

  27. Barrett's esophagus Intestinal metaplasia normal squamous into columnar.

  28. What is Dysplasia?

    Disordered growth, loss of uniformity. Pleomorphism N/C ratio increased Dark, hyperchromatic nuclei Mitotic figures

  29. What is going on?

    Cervical Dysplasia in Pap Smear. Top is normal, bottom is dysplastic.

  30. Two components of neoplasm Parenchyma Proliferative neoplastic cells 2.Reactive stroma CT, desmoplastic response, inflammatory cells, blood vessels Picture of squamous cell carcinoma of tongue.

  31. Teratoma Derived from multiple cell layers and germ layers. Totipotent cells Ovary, testis.

  32. What are the malignant neoplasm ending in "-oma?" What is anaplasia?

    Melanoma Lymphoma Seminoma Mesothelioma Astrocytoma Anaplasia is lack of differentiation.

  33. Well-differentiated squamous cell carcinoma Well differentiated look for: Interceullular bridges Keratin pearls Intercellular bridges made of desmosomes.

  34. Features of anaplasia Pleomorphism Mitosis (-->) Irregular nuclei, hyperchromasia Tumor giant cells ( 0 )

  35. What is a Familial Retinoblastoma?

    Mutation in Rb tumor suppressor gene. Needs 2nd mutation for malignancy. Osteosarcoma risk. pRB is phosphorlyated by CDK which inactivates RB and starts cell cycle. Rb+E2F --> RbP + E2F --> cell cycle.

  36. Squamous cell carcinoma of bladder caused by Schistosoma haematobium. There are Eosinophils in slide.

  37. How do Alkylating agents, tobacco, and Aflatoxin B1 cause cancer?

    Alkylate DNA --> alter DNA base pairing. May treat or cause cancer. Tobacco creates polycyclic aromatic hydrocarbons. Aflatoxin B1 from fungus cause mutation in p53 and intercalting agents. Most potent liver cancer chemical.

  38. What does HPV do? What does Hepatitis B and C do? What does Helicobacter pylori do?

    Causes cervical SCC. Viral proteins E6 and E7 block p53 and Rb. Hepatitis causes hepatocellular carcinoma. Heli. pylori causes gastric lymphoma of MALT. Antibiotics may result in remission despite neoplasm removal stimuli theory.

  39. Retinoblastoma Flexner-Wintersteiner rosettes

  40. How to treat Breast Cancer?

    HR positive + HER2 positive use chemo, trastuzumab, endocrine therapy. HR positive + HER2 negative use chemo, endocrine therapy. HR negative + HER2 positive use trastuzumab and Chemo HR negative + HER2 negative CHEMO only.

  41. Non-small cell lung cancers causes and treatments?

    Adenocarcinoma, Squamous cell carcinom, Large cell carcinoma EML4-ALK fusion stimulates growth-factor independent proliferation. Alectinib binds tyrosine-kinase on ALK and inhibits.

  42. Treatment for seizures?

    IV benzos, Lorazepam. Prophylactic: use VGNa+ channel compound like Carbamazepine or Valproic acid. Or decrease glutamate release via Levetiracetam.

  43. Non-small cell lung cancer. EML4-ALK Fusion.

  44. What does CYP2D6 do?

    Metabolize metoprolol. -AA and whites have slow metabolism. -Arabs have rapid metabolism.

  45. What does CYP2C19 do?

    Metabolism of Clopidogrel (Plavix) to active metabolite; prodrug. 30% have defeciency Low levels of CYP2C19 need HIGHER dose of clopidogrel.

  46. What does CYP2C9 and VKORC1 do?

    CYP2C9 metabolizes Warfarin. Warfarin inhibits VKORC1 needed to activate Vit. K for II, X, XI, XII clotting cascade. VKORC1 increases sensitivity to Warfarin.

  47. What does Pseudocholinesterase deficiency do?

    Increases relaxed muscle time via Succyicholine. Prolonged apnea. Can't break down Succyincholine. Persian Jews and Alaska natives.

  48. What does G6PD deficiency do?

    X-linked disease, hemolytic anemia. Heinz bodies, blister cells.

  49. What does SCLO1B1 do?

    Gene for anion transporter OATP1B1 for statin uptake by liver. Increased plasma conc. of statins, loss of efficacy, and increased side effects. Statins inhibit HMG-CoA reducatase needed for cholesterol synthesis.

  50. What does RYR1 do?

    In skeletal muscle, releases Ca2+ from ER. Mutation causes opening of RYR channel, increasing Ca2+ release. Muscle ridigity, increased body temp, acidosis. Use dantrolene as antagonist of ryanodine receptor.

  51. What does antidote for acetaminophen poisoning do?

    It adds a sulfhydryl (-SH) group to detoxify a reactive metabolite.

  52. What diseases do Strep pyogenes Group A cause?

    Strep throat M proteins very immunogenic, suggests autoimmune disease, cause Rheumatic fever

  53. Which antibiotic has risk of tendon damage and what does it do?

    Ciprofloxacin DNA gyrase inhibitor, stops supercoiling.

  54. Name the cell wall inhibitor antibiotics?

    Penicllin Naficillin Amoxicillin Imipenem Aztreonam Vancyomycin - Red Man Syndrome. Cefazolin -Red Man Syndrome, nephrotoxicity.

  55. What is Klebsiella?

    K. pneumoniae is a bacteria that normally lives in intestines. May spread to other parts of body, cause infection. Gram negative, Baccilli rod, lactose ferment. (with e.coli and enterobacter). UTIs

  56. What causes paular rash with Pastia's lines in antecubital fossae?

    Group A streptococcus. S. pyogenes B-hemolytic Has a capsule prevents phagocytosis and M-protein to gain entry into host.

  57. What are the encapsulated bacteria?

    Some, Killers, Have, Pretty, Nice, Capsules Strep. pneumoniae Klebsiella pneumoniae Haemophilus influenza Pseudomonas aerugionsa Neisseria meningitidis Cryptococcus Neoformans

  58. Emphysema Top: Centriacinar emphysema, smokers Bottom: Panacinar emphysema.

  59. Name the types of Amyloidosis

    AL - plasma protein disorder, Primary. Amyloid light chains. AA - Systemic inflammatory. Causes RA. AB - Beta amyloid, Alzheimer's disease.

  60. What is LECT 2 amyloid?

    Systemic amyloidosis. LECT2 secreted by liver, deposits in kidney, kidney failure. 85% are Hispanic.

  61. What is Familial Mediterranean Fever?

    Hereditary amyloidosis Excess IL-1 production. Mutation of TTR encoding pyrin which regulates inflammation. AA fibril protein in peripheral and ANS.

  62. Systemic Senile Amyloidosis Due to aging. NORMAL TTR. In heart. Top arrow is amyloid. Bottom is cardiac muscle.

  63. Advatnages and disadvantages of Adenovirus vectors, Adenovirus-associated vector, and Lentiviral Vectors?

    Advantage: Large DNA payload, high infection efficiency Disadvantage: HIGH rate of immune response. Not stably integrated into genome. Advantage: non-pathogenic Disadvantage: Small payload. Lentiviral vector from human retrovirus (HIV). Use 3 vectors for safety. Disadvantage: gene activation.

  64. Describe Type I, II, III, & IV hypersensitivity

    Type I is IMMEDIATE. IgE release, release of vasoactive amines and mediators from mast cells. Tissue injury Type II is Ab-mediated IgG, IgM bind to antigen induce phagocytosis. Recruit WBCs. No tissue injury. Autoimmune hemolytic anemia. Goodpastures, Graves, Myasthenia gravis. Type III is immune complex Complement activation. Inflammation, necrotizing vasculitis. Systemic Lupus Erythematosus, Serum Sickness, Type IV is cell-mediated Activated T-CELLS. Release cytokines, macrophage activation C…

  65. What is Goodpasture's Syndrome

    Anti-GBM disease, Type II hypersensitivity. Antibodies attack basement membrane of kidney and lungs. Necrosis in kidney Lung alveolar filled with blood. Pulmonary hemorrhage.

  66. What is Post-streptococcal Glomerulonephritis?

    Type III hypersensitivity. Ab-Ag complex lodge in glomerulus.

  67. Describe Type IV hypersensitivity

    CD4 T-cells bind with APC release cytokines and cause damage via macrophages and PMNs. Form granulomas. Macrophages turn into epitheloid cells and fuse (giant cells). Contact dermatitis TB Sarcoidosis

  68. ANA characterization of SLE?

    Use ELISA for subtype of antinuclear antibody.

  69. Describe skin biospy in SLE

    Granular deposits seen along epidermis and dermis border.

  70. What is Sjogren Syndrome?

    Autoimmune disease attacks lacrimal and salivary glands. Swollen parotid glands.

  71. What is Shigella?

    Gram negative bacilli, non lactose ferment. From fingers, feces, flies, food. Low ID50. Bloody diarrhea. **Salmonella has HIGH ID50.

  72. What is Pseudomonas auerginosa?

    Gram negative bacilli, motile, non lactose ferment. Grape like odor. Pneumonia, sepsis, Ecthyma gangrenosum, UTIs, Diabetes, Osteomyelitis, Mucoid capsule, Otitis, Nonsocmial infections, addicts, skin infection

  73. What is molecular mimicry?

    Infection induces cross-reactive lymphocytes. Rheumatic fever: B cell Abs for sttrep corss react with CT antigen, especially in heart valves.

  74. Name the drug class for HIV that block reverse transcriptase

    NRTI = Zidovudine (ZDV, AZT) NNRTI = Delavirdine

  75. HIV therapy protease inhibitor?

    Atazanavir Protease needed to cleave from host carrier, prevent maturation. Side effect of "camel hump"

  76. HIV therapy fusion inhibitors

    Enfuvirtide - blocks gp41 for fusion Maraviroc - blocks gp120 for docking

  77. What antifungal for onychomycosis (fungal infection of nail)?

    Terbinafine, inhibits squalen epoxidase.

  78. What are Echinocandins? Griseofulvin

    Caspofungin, Micafungin, Anidulafungin "-FUNGIN" Inhibit B-glucan synthesis. Use for invasive fungal infections.

  79. What does Griseofulvin do and treat?

    Treats ring worm, athletes foot. Prevents nucleic acid synthesis.

  80. What does Rifampin do?

    mRNA synthesis inhibitor Side effect: dark urine joint pain.

  81. Describe Cytomegalovirus

    Infectious mono. Congenital microcephaly, periventricular calcifications, Hearing loss.

  82. Describe Measles

    Three 'Cs' Cough, Coryza (snot nose), Conjunctivits. Cranial to Caudal.

  83. Describe Coxsackievirus

    Posterior pharyngeal vesicles, lesions in back of throat. VERY painful.

  84. What is VEGF?

    Growth factor for angiogenesis. Healing phase of chronic inflammation. Plays a role in tumor growth.

  85. What is TGF-B?

    Growth factor, potent simulator of fibrosis, proliferation of fibroblasts, production of collagen.

  86. Granulation tissue. Proliferation of new small blood vessels, often leaky, through VEGF. New collagen type 3 matures to type I, TGF-B.

  87. Heart graft rejection. Type IV hypersensitivity. Invasion of lymphocytes.

  88. What are Antinuclear Antibodies (ANA)?

    Present with autoimmune diseases. Attacks nuclear antibodies. Some people have ANA but no symptoms.

  89. Antinuclear Antibody ANA test for SLE?

    Antibody against dsDNA. Antibody to Smith (Sm) antigen. Antibody against phospholipid membranes. In vivo causes INCREASED clotting. However, in vitro (test tube) will cause delayed clotting.

  90. What is the pygmalion effect?

    Greek sculpture fell in love with own reflection. Doctors fall in love with own hypothesis and ignore other things.

  91. Type I and Type II errors?

    Type I error is rejecting null hypothesis when it is correct. Saying there is significant difference when there is NOT. Type II is failing to reject null hypothesis despite it being false. Saying there is no significant difference when there actually is.

  92. Describe Indomethacin

    NSAID relieves pain and inflammation. Used for ductus arteriosus (Alprostadil for surgery).